Drugs linked to disease

I doubt if one person in a million has ever heard of rhabdomyolysis -- least of all been able to spell it. But recently, this disease made us all sit up and take notice.

This happened when Bayer Pharmaceuticals suddenly withdrew Baycol, its cholesterol-lowering drug (CLD), from the market. Baycol has been linked to deaths from rhabdomyolysis. What is this disease and are other CLDs safe?

Rhabdomyolysis occurs when skeletal muscle is injured. This results in the release of toxic cellular components into blood circulation causing damage to kidneys. The result may be complete kidney failure and death.

The telltale signs of rhabdomyolysis are muscle aches and pains not associated with rigorous physical activity.

This is not a new disease. During World War II many people suffered severe injuries to muscles from being crushed by buildings. Some of these victims died from rhabdomyolysis.

Bayer is to be commended for quickly withdrawing a drug that had generated mega-millions of dollars. But it now appears some deaths linked to Baycol occurred from patients not following directions. Bayer had repeatedly warned that Baycol should not be taken along with Lopid, another CLD.

But one has to ask, if Baycol causes this problem, why are other CLDs still available? Particularly when it's been reported these drugs are also linked to rhabdomyolysis, but to a lesser degree.

So what should patients who have been prescribed CLDs do? First of all, these reported deaths and kidney failures only prove once again that no drug is without side-effects. And today, with so many patients taking several drugs at once, interactions are more likely.

In 1998, I wrote that patients taking CLDs Mevacor, Zocor and Lipitor should not drink grapefruit juice.

Studies showed that grapefruit juice could increase the blood level of Mevacor 15 times. It was like taking 15 times the normal dose of Mevacor. And the continued use of grapefruit juice may result in rhabdomyolysis.

So patients should always ask themselves, "If something like grapefruit juice can pack such a powerful counter punch, what about other drug combinations?" After all, it's not as if these patients had poured themselves a three-ounce Martini!

Cardiologists stress that thousands of lives have been saved by CLDs, so don't toss out the baby with the bath water. They suggest patients switch to one of the other five CLDs. After all, millions of patients have been taking these drugs without dying from rhabdomyolysis.

This appears to be the prudent move at the moment. But it is a wake-up call that we must all be careful about medication. You rarely get something for nothing, and the medical world is still not sure of the long-term effects of CLDs.

For instance, Dr. Evelyn Hess, professor of medicine at The University Of Cincinnati Medical School in Ohio, issued a recent warning. She told doctors at the ninth International Congress Of Toxicology in Brisbane, Australia, that some patients on CLDs have developed the Lupus Syndrome and that although natural Lupus occurs in women, drug-related Lupus strikes both sexes.

I have always been skeptical about such widespread use of CLDs. How much consumption is driven by sound scientific medicine? How much "cholesterolphobia" is generated by TV and the resulting profit made by pharmaceutical companies?

Now, more millions of patients may be placed on this medication. A recent report in May from The National Cholesterol Education Program says cholesterol levels in North Americans should be dropped even further. This means that in North America, the 13 million now taking CLDs would be increased to 36 million.

One wonders if so many millions of people are really that ill? And, if so, surely all this medication isn't good for the body. Rather than massive amounts of drugs, perhaps we need a massive change in lifestyle to prevent cardiovascular disease.

I admit that since my heart attack three years ago and the subsequent bypass surgery, I take a CLD. And every time I swallow one, I wonder if it's the right move.

So why do I do it? Because it's been aptly said, "He who treats himself has a fool for a patient." And several heart specialists have said I'd be a fool not to take them.

If you're on a CLD drug, be sure to tell your doctor if you develop unexplained muscle aches and pain. And make certain you have regular blood tests to check on the health of your liver and kidneys.